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Old 10-23-2010
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Drug Prostatic Carcinoma Drug of choice

what is the first line of drug in a prostatic ca with spinal metastasis?
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Old 10-24-2010
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Arrow hormonal therapy

Since this is an advanced metastatic prostate cancer then surgery is not an option and you go with supportive therapy which is usually in the form of hormonal therapy.

Hormonal therapy can either be performed with removal of the testicles (orchiectomy) or with drugs

Most patient prefer drugs.

The most commonly used are Leuprolide (LHRH analogue) and Flutamide (Antiandrogen)

Don't confuse these two drugs with Finasteride (5 alpha reductase inhibitor) which is used in BPH only.

There's a nice thread about prostate CA therapy here

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Old 10-25-2010
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If we have to choose between the drugs used for hormonal therapy. Then the single drug of choice should be GnRH analogs (Nafaralin, Gosereline, Leuprolide, Histrelin, and Buserelin)

As the pt has spinal metastasis
Originally Posted by Sarah-cali View Post
When you give flutamide (which is an androgen receptor blocker) you will after some time inhibit the negative feedback that Testosterone has on the pituitary ----> Increased LH ----->Leydig cell stimulation ----> Increased gonadal Testosterone secretion.
This increase in testosterone can increase the tumor size which can further complicate the neurological symptoms caused by the tumor.

I hope this answers your question....
Knowing is not enough; we must apply.
Willing is not enough; we must do.
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Sabio (10-25-2010)


Pathology-, Pharmacology-

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